Cocaine - Questions and Answers
What is Cocaine?
Cocaine, the most potent stimulant of natural origin, is extracted from the leaves of the coca plant (Erythroxylon coca), which is indigenous to the Andean highlands of South America. It is a potent brain stimulant and one of the most powerfully addictive drugs. Cocaine is produced as a white chunky powder. It is sold most often in aluminum foil, plastic or paper packets, or small vials. Cocaine is usually chopped into a fine powder with a razor blade on a small mirror or some other hard surface, arranged into small rows called "lines," then quickly inhaled (or "snorted") through the nose with a short straw or rolled up paper money. It can also be injected into the blood stream.
What are the slang terms commonly associated with cocaine?
Street drug language changes all of the time, so as soon as a list is published it's somewhat out of date. The slang used for cocaine in your area may include some of these terms and/or some totally new terms. Big C, Big Flake, Blow, Bump, C, Caine, Candy, Charlie, Coca, Coke, Do a Line, Dust, Nose Candy, Powder, Snort, Sniff, Soda, Speedball, and Yeyo (Spanish).
How much does Cocaine cost?
Cocaine prices depend upon the purity of the product. In 2001, cocaine purity declined by 8 percent, from 86 percent pure in 1998 to a 78 percent pure in 2001. The decrease in purity indicates a decrease in the supply of cocaine in the United States. Cocaine remained low and stable, which suggests a steady supply to the United States. Nationwide, prices ranged from $12,000 to $35,000 per kilogram.
How is cocaine used?
There are four primary methods of ingesting cocaine. These are:
1. "Snorting" - absorbing cocaine through the mucous membranes of the nose.
2. Injecting - users mix cocaine powder with water and use a syringe to inject the solution intravenously.
3. Freebasing - Cocaine hydrochloride is converted to a "freebase" which can then be smoked.
4. Crack Cocaine - Cocaine hydrochloride is mixed with ammonia or sodium bicarbonate (baking soda) and other ingredients, causing it to solidify into pellets or "rocks". The crack is then smoked in glass pipes.
What are the symptoms of Cocaine use?
The symptoms of Cocaine use include but are not limited to:
• anxiety
• panic
• bloody nose
• increased energy
• talking rapidly
• rapid pulse and respiration
• paranoia
• confusion
• dilated pupils
• hallucinations
• altered motor activities (tremors, hyperactivity)
• stuffiness
• runny nose
What Paraphernalia is Commonly Associated with Cocaine?
Paraphernalia associated with inhaling cocaine includes mirrors, razor blades, straws, and rolled paper money. Paraphernalia associated with injecting the drug include syringes, needles, and spoons, along with belts, bandanas, or surgical tubing used to constrict the veins. Scales are used by dealers to weigh the drug. Sometimes substances such as baking soda or mannitol are used to "cut" cocaine in order to dilute the drug and increase the quantity of the drug for sale.
What is Cocaine addiction?
Cocaine addiction can occur very quickly and can be very difficult to break. Animal studies have shown that animals will work very hard (press a bar over 10,000 times) for a single injection of cocaine, choose cocaine over food and water, and take cocaine even when this behavior is punished. Animals must have their access to cocaine limited in order to prevent taking toxic or even lethal doses. Researchers have found that cocaine stimulates the brain's reward system inducing an even greater feeling of pleasure than natural functions. In turn, its influence on the reward circuit can lead a user to bypass survival activities and repeat drug use. Chronic cocaine use can lead to a cocaine addiction and in some cases damage the brain and other organs. An addict will continue to use cocaine even when faced with adverse consequences. Dependency can develop in less than 2 weeks. Some research indicates that a psychological dependency may develop after a single dose of high-potency cocaine. As the person develops a tolerance to cocaine, higher and higher doses are needed to produce the same level of euphoria.
How does Cocaine effect the brain?
Through the use of sophisticated technology, scientists can actually see the dynamic changes that occur in the brain as an individual takes cocaine. They can observe the different brain changes that occur as a person experiences the "rush," the "high," and finally the craving of cocaine. They can also identify parts of the brain that become active when a cocaine addict sees or hears environmental stimuli that trigger the craving for cocaine.
Researchers know that certain kinds of experiences, such as those involved in learning, can physically change brain structure and affect behavior. Now, new research in rats shows that exposure to stimulant drugs such as cocaine can impair the ability of specific brain cells to change as a consequence of experience. "The ability of experiences to alter brain structure is thought to be one of the primary mechanisms by which the past can influence behavior and cognition," says NIDA Director Dr. Nora D. Volkow. "However, when these alterations in brain structure are produced by drugs of abuse, they may lead to the development of compulsive patterns of drug-seeking behaviors that are the hallmark of addiction."
The researchers conducted a series of experiments to examine how drugs of abuse and experience might interact to produce changes in brain structure. To accomplish this, they administered amphetamine, cocaine, or saline repeatedly for 20 days to individually housed rats. This pattern of drug administration was previously shown by these investigators to produce both behavioral changes in response to the drugs and structural changes in several brain regions. However, in the current study, the researchers went one step further. After the 20-day drug exposure, the rats were housed in a new environment for 3 to 3.5 months. Half of the drug- and saline-injected animals were placed in standard laboratory cages; the other animals in each group were housed in a complex environment. The environment contained a variety of stimuli: multiple levels with ramps, bridges, a climbing chain, tunnels, and toys that were rearranged once a week to encourage continued exploration of the environment. At the end of 3 or 3.5 months, the rats' brains were analyzed for changes in dendritic branching and spine density. Specifically, the researchers examined the spiny neurons in the nucleus accumbens and the pyramidal cells in the parietal cortex. These areas were shown in previous studies to be altered by experience and/or drugs of abuse. The nucleus accumbens is involved in motivation and reward, and the parietal cortex is important for sensory-motor function.
Remarkably, animals that had been given amphetamine and then placed in the complex environment did not show the same environmental-induced structural changes in the nucleus acccumbens and parietal cortex as did saline-treated animals in the complex environment. The results for those animals treated with cocaine were similar, in that prior treatment with cocaine blocked the environment-induced changes in the medium spiny neurons of the nucleus accumbens (the only region examined). "The findings from this study indicate that at least some of the cognitive and behavioral advantages that accrue with experience may be diminished by prior exposure to psychostimulant drugs," says Dr. Kolb. "This impairment of the ability of specific brain circuits to change in response to experiences may help explain some of the behavioral and cognitive deficits seen in people who are addicted to drugs. More research is warranted to determine whether certain experiences, such as exposure to complex or rewarding environments, can alter the ability of drugs to induce structural changes in the brain. If exposure to psychostimulant drugs can alter the effects of subsequent experience, experience may be able to influence the later effects of drugs. It may even be possible for certain experiences to counteract the effects of psychostimulant drugs."
What are the symptoms of Cocaine addiction?
The symptoms of Cocaine addiction include but are not limited to:
• cardiac problems
• neglect of family responsibilities
• ignoring job demands
• social isolation
• neglect of body needs and hygiene
• disintegration of the mucous membrane
• collapse of the nasal septum
• selling of personal property
• mood swings
• weight loss
• change in friends
• change in daily schedule (staying out all night)
• always having a stuffy, runny nose
• constant loss of appetite
Why would anyone become addicted to Cocaine?
The effects of cocaine are immediate, extremely pleasurable, and brief. Cocaine produce intense but short-lived euphoria and can make users feel more energetic. Like caffeine, cocaine produces wakefulness and reduces hunger. Psychological effects include feelings of well-being and a grandiose sense of power and ability mixed with anxiety and restlessness. As the drug wears off, these temporary sensations of mastery are replaced by an intense depression. The drug abuser will then "crash", becoming lethargic and typically sleeping for several days.
How widespread is cocaine addiction?
• In 1997, there were approximately 1.5 million regular cocaine abusers.
• 1-tenth of the population - over 22 million people have tried cocaine.
• Each day 5,000 more people will experiment with cocaine.
• Cocaine is a $35 billion illicit industry now exceeding Columbia's #1 export, coffee.
• 1 in 10 workers say they know someone who uses cocaine on the job.
• The annual number of new cocaine users has generally increased over time. In 1975, there were 30,000 new users. The number increased from 300,000 in 1986 to 361,000 in 2000.
• The average age of cocaine initiates rose from 17.2 years in 1967 to 23.8 years in 1991 and subsequently declined to approximately 20 years from 1997 to 2000.
• Cocaine addiction was responsible for 14 % of the 1.6 million admissions in 1999 to publicly funded drug addiction facilities.
In 1997, an estimated 1.5 million Americans (0.7 percent of those age 12 and older) were current cocaine users, according to the 1997 National Household Survey on Drug Abuse (NHSDA). This number has not changed significantly since 1992, although it is a dramatic decrease from the 1985 peak of 5.7 million cocaine users(3 percent of the population). Based upon additional data sources that take into account users underrepresented in the NHSDA, the Office of National Drug Control Policy estimates the number of chronic cocaine users at 3.6 million. Adults 18 to 25 years old have a higher rate of current cocaine use than those in any other age group. Overall, men have a higher rate of current cocaine use than do women. Also, according to the 1997 NHSDA, rates of current cocaine use were 1.4 percent for African Americans, 0.8 percent for Hispanics, and 0.6 percent for Caucasians. Cocaine remains a serious problem in the United States. The NHSDA estimated the number of current cocaine users to be about 604,000 in 1997, which does not reflect any significant change since 1988. The 1998 Monitoring the Future Survey, which annually surveys teen attitudes and recent drug use, reported that lifetime and past-year use of cocaine increased among eighth graders to its highest levels since 1991, the first year data was available for this grade. The percentage of eighth graders reporting cocaine use at least once in their lives increased from 2.7 percent in 1997 to 3.2 percent in 1998. Past-year use of cocaine also rose slightly among this group, although no changes were found for other grades. Data from the Drug Abuse Warning Network (DAWN) showed that cocaine-related emergency room visits, after increasing 78 percent between 1990 and 1994, remained level between 1994 and 1996, with 152,433 cocaine-related episodes reported in 1996.
How does cocaine produce its effects?
A great amount of research has been devoted to understanding the way cocaine produces its pleasurable effects, and the reasons it is so addictive. One mechanism is through its effects on structures deep in the brain. Scientists have discovered regions within the brain that, when stimulated, produce feelings of pleasure. One neural system that appears to be most affected by cocaine originates in a region, located deep within the brain, called the ventral tegmental area (VTA). Nerve cells originating in the VTA extend to the region of the brain known as the nucleus accumbens, one of the brain's key pleasure centers. In studies using animals, all types of pleasurable stimuli, such as food, water, sex, and many drugs of abuse, cause increased activity in the nucleus accumbens.
Researchers have discovered that, when a pleasurable event is occurring, it is accompanied by a large increase in the amounts of dopamine released in the nucleus accumbens by neurons originating in the VTA. In the normal communication process, dopamine is released by a neuron into the synapse (the small gap between two neurons), where it binds with specialized proteins (called dopamine receptors) on the neighboring neuron, thereby sending a signal to that neuron. Drugs of abuse are able to interfere with this normal communication process. For example, scientists have discovered that cocaine blocks the removal of dopamine from the synapse, resulting in an accumulation of dopamine. This buildup of dopamine causes continuous stimulation of receiving neurons, probably resulting in the euphoria commonly reported by cocaine abusers. As cocaine abuse continues, tolerance often develops. This means that higher doses and more frequent use of cocaine are required for the brain to register the same level of pleasure experienced during initial use. Recent studies have shown that during periods of abstinence from cocaine use, the memory of the euphoria associated with cocaine use or mere exposure to cues associated with drug use, can trigger tremendous craving and relapse to drug use even after long periods of abstinence.
What are the physical effects of cocaine addiction?
With the accumulating medical evidence of cocaine's deleterious effects and the introduction and widespread use of cocaine, the public and government have become alarmed again about its growing use. To many Americans, especially health care and social workers who deal with cocaine users and have witnessed the personal and societal devastation it produces, cocaine addiction is by far the most serious drug problem in the United States.
Cocaine use increases the risk of sudden heart attack and may also trigger stroke, even in users who otherwise are not at high risk for these sometimes fatal cardiovascular events. The risk is related to narrowing of blood vessels and increases in blood pressure and heart rate. Recently, NIDA-supported researchers at the Alcohol and Drug Abuse Research Center at McLean Hospital in Belmont, Massachusetts, have identified changes in blood components that may also play a role in cocaine-related heart attack and stroke. The physical effects of cocaine addiction include but are not limited to:
• Changes in blood pressure, heart rates, and breathing rates
• Nausea
• Vomiting
• Anxiety
• Convulsions
• Insomnia
• Loss of appetite leading to malnutrition and weight loss
• Cold sweats
• Swelling and bleeding of mucous membranes
• Restlessness and anxiety
• Damage to nasal cavities
• Damage to lungs
• Possible heart attacks, strokes, or convulsions
What are the short term effects of Cocaine?
Cocaine's effects appear almost immediately after a single dose, and disappear within a few minutes or hours. Taken in small amounts (25 to 150 mg), cocaine usually makes the user feel euphoric, energetic, talkative, and mentally alert, especially to the sensations of sight, sound, and touch. It can also temporarily decrease the need for food and sleep. Some users find that the drug helps them to perform simple physical and intellectual tasks more quickly, while others can experience the opposite effect.
The short-term effects of cocaine include but are not limited to:
• Increased energy
• Decreased appetite
• Mental alertness
• Increased heart rate
• Increased blood pressure
• Constricted blood vessels
• Increased temperature
• Dilated pupils
• A feeling of euphoria
• Excitement
• A feeling of strength and power
The duration of cocaine's immediate euphoric effects depends upon the route of administration. The faster the absorption, the more intense the high. Also, the faster the absorption, the shorter the duration of action. The high from snorting is relatively slow in onset, and may last 15 to 30 minutes, while that from smoking may last 5 to 10 minutes. The short-term physiological effects of cocaine include constricted blood vessels; dilated pupils; and increased temperature, heart rate, and blood pressure. Large amounts (several hundred milligrams or more) intensify the user's high, but may also lead to bizarre, erratic, and violent behavior. These users may experience tremors, vertigo, muscle twitches, paranoia, or, with repeated doses, a toxic reaction closely resembling amphetamine poisoning. Some users of cocaine report feelings of restlessness, irritability, and anxiety. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest. Various doses of cocaine can also produce other neurological and behavioral effects such as:
• dizziness
• headache
• movement problems
• anxiety
• insomnia
• depression
• hallucinations
What are the long term effects of cocaine?
Cocaine is a powerfully addictive drug. Once having tried cocaine, an individual may have difficulty predicting or controlling the extent to which he or she will continue to use the drug. Cocaine's stimulant and addictive effects are thought to be primarily a result of its ability to inhibit the reabsorption of dopamine by nerve cells. Dopamine is released as part of the brain's reward system, and is either directly or indirectly involved in the addictive properties of every major drug of abuse.
The long-term effects of cocaine include but are not limited to:
• Irritability
• Mood disturbances
• Restlessness
• Paranoia
• Auditory hallucinations
• Addiction
An appreciable tolerance to cocaine's high may develop, with many addicts reporting that they seek but fail to achieve as much pleasure as they did from their first experience. Some users will frequently increase their doses to intensify and prolong the euphoric effects. While tolerance to the high can occur, users can also become more sensitive (sensitization) to cocaine's anesthetic and convulsant effects, without increasing the dose taken. This increased sensitivity may explain some deaths occurring after apparently low doses of cocaine. Use of cocaine in a binge, during which the drug is taken repeatedly and at increasingly high doses, leads to a state of increasing irritability, restlessness, and paranoia. This may result in a full-blown paranoid psychosis, in which the individual loses touch with reality and experiences auditory hallucinations.
What are the medical complications of cocaine use?
There are enormous medical complications associated with cocaine use. Medical consequences of cocaine abuse:
• Cardiovascular effects - disturbances in heart rhythm, heart attacks
• Respiratory effects - chest pain, respiratory failure
• Neurological effects - strokes, seizures, headaches
• Gastrointestinal effects - abdominal pain, nausea
Cocaine use has been linked to many types of heart disease. Cocaine has been found to trigger chaotic heart rhythms, called ventricular fibrillation; accelerate heartbeat and breathing; and increase blood pressure and body temperature. Physical symptoms may include chest pain, nausea, blurred vision, fever, muscle spasms, convulsions and coma.
What are the symptoms of cocaine withdrawal?
Regular use of cocaine can lead to strong psychological dependence (addiction). Those who abruptly stop their cocaine use can experience cocaine addiction withdrawal symptoms as they readjust to functioning without the drug. The length of cocaine addiction withdrawal varies from person to person and also depends on the amount and frequency of use. Cocaine addiction withdrawal symptoms include but are not limited to:
• agitation
• depression
• intense craving for the drug
• extreme fatigue
• anxiety
• angry outbursts
• lack of motivation
• nausea/vomiting
• shaking
• irritability
• muscle pain
• disturbed sleep
What are the symptoms of a cocaine overdose?
The symptoms of a cocaine overdose are intense and generally short in nature. Although fairly uncommon, people do die from cocaine overdose. The exact amount of cocaine that causes an overdose varies from person to person and is dependent on a variety of factors including weight, metabolism, health etc. Cocaine is often "cut" with various adulterants. This increases the risk of overdose, since the purity of cocaine is difficult to determine. An overdose from cocaine can cause a serious increase in blood pressure, which can cause bleeding in the brain leading to a higher possibility of a stroke. A cocaine overdose can cause heart and respiratory problems resulting in death. Symptoms of cocaine overdose may include some or all of the following:
• Dangerous or fatal rise in body temperature
• Seizures
• Heart attack
• Brain hemorrhage
• Kidney failure
• Stroke
• Repeated convulsions
• Tremors
• Delirium
• Death
What is the History of Cocaine?
Cocaine is derived from the leaves of the coca bush, which grows in South America. Cocaine has been used for centuries by Indians to combat the effects of hunger, hard work, and thin air. In the mid 1800s its effects were praised by Freud, among others. Until 1906, this substance was a chief ingredient of Coca-Cola and was also used as a anesthetic. Widespread use and addiction led to government efforts against cocaine in the early 1900s. The danger associated with cocaine was ignored in the 1970s and early 1980s, and cocaine was proclaimed by many to be safe. With the accumulating medical evidence of cocaine's deleterious effects and the introduction and widespread use of cocaine, the public and government have become alarmed again about its growing use.
